扁桃体术后患者医院感染病原菌及药敏分析

Pathogens causing nosocomial infections in patients after tonsillectomy and the drug susceptibility testing

目的观察扁桃体术后患者医院感染的临床特点,以积累经验,为临床治疗提供依据。方法采用回顾性调查分析80例扁桃体术后感染的患者,对其进行医院感染发生部位、病原菌种类统计,观察药敏结果及预后的影响。结果 80例患者发生手术伤口感染56例,占70.00%,肺部感染21例,占26.25%,耳部感染3例,占3.75%;共检出病原菌117株,革兰阳性菌71株占60.68%,以酿脓链球菌和金黄色葡萄球菌最多,革兰阴性菌46株占39.32%,以铜绿假单胞菌和肺炎克雷伯菌最多;革兰阳性菌中酿脓链球菌和金黄色葡萄球菌对万古霉素、头孢硫咪和氨苄西林/舒巴坦敏感;革兰阴性菌中铜绿假单胞菌和肺炎克雷伯菌对亚胺培南高度敏感。结论扁桃体围术期要严格执行无菌观念,临床应加强预防医院感染的管理,减少医院感染的发生,对感染的患者及时进行分泌物细菌培养及耐药性的检测,对指导临床合理用药具有重要意义。

OBJECTIVE To investigate the clinical characteristics of nosocomial infections in patients undergoing tonsillectomy so as to provide basis for the clinical treatment. METHODS By means of the retrospective survey, totally 80 with nosocomial infections who underwent the tonsillectomy were observed. The infection sites and the species of the pathogens were statistically analyzed, and the drug susceptibility results and the prognosis were studied. RESULTS Of 80 patients investigated , the surgical incision infections occurred in 56 cases with the infec-tion rate of 70.00%, the pulmonary infections in 21 cases （26.25%）, the ear infections in 3 cases （3.75%）. A total of 117 strains of pathogens were isolated, including 71 （60.68%） strains of gram-positive bacteria and 46 （39.32%） strains of gram-negative bacilli. Streptococcus pyogenes and Staphylococcus aureus were the predomi-nant species of the gram-positive bacteria, and Pseudomonas aeruginosa and Klebsiella pneumoniae were dominant in the gram-negative bacteria. S. pyogenes and S. aureus were sensitive to vancomycin, cephathiamidine and am-picilllin/sulbactarn; and P. aeruginosa and K. pneumoniae were highly sensitive to imipenem. CONCLUSION The aseptic operation is important to the tonsillectomy. The control of nosocomial infections should be strengthened to reduce the incidence of nosocomial infections. It is of great significance to the reasonable use of antibiotics to per-form the bacterial culture for the secretions and to test the drug resistance.